Why preventive care is important

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Acute nephritic syndrome

Definition
Acute nephritic syndrome is a group of disorders that cause inflammation of the internal kidney structures (specifically, the glomeruli).

Causes, incidence, and risk factors

Acute nephritic syndrome is often caused by an immune response triggered by an infection or other disease.

Casues seen more frequently in children and adolescents include the following:

IgA nephropathy

Henoch-Schonlein purpura

Hemolytic uremic syndrome

Post-streptococcal glomerulonephritis

Associated diseases seen more frequently in adults include:

SLE or lupus nephritis

Membranoproliferative GN I

Membranoproliferative GN II

Infective endocarditis

Vasculitis

Rapidly progressive (crescentic) glomerulonephritis

Goodpasture’s syndrome

Klebsiella pneumonia

Abdominal abscesses

Viral diseases such as mononucleosis, measles, mumps

Typhoid fever

Hepatitis

Syphilis and other sexually transmitted diseases

Inflammation disrupts the functioning of the glomerulus, which is the part of the kidney that controls filtering and excretion. This inefficient functioning results in blood and protein appearing in the urine, and the accumulation of excess fluid in the body. Swelling results when protein is lost from the blood stream. (Protein maintains fluid within the blood vessels, and when it is lost the fluid collects in the tissues of the body).

Urine discoloration results from blood in the urine. This occurs because of loss of blood within the damaged glomeruli.

Acute nephritic syndrome may be associated with the development of high blood pressure, interstitial inflammation (inflammation of the spaces between the cells of the kidney tissue), and acute kidney failure.

Symptoms

Despite the diversity of diseases that cause acute nephritis below, they share many symptoms in common:

Difficulty breathing, especially at night, while lying down, or from exercise

Flank pain

High blood pressure

Signs and tests

Your blood pressure may be elevated. There may be signs of fluid overload (more fluid in circulation than the heart can effectively pump), including abnormal heart and lung sounds. The jugular (neck) veins may be distended from increased pressure.

Generalized swelling is often present. When examining your abdomen, your health care provider may find signs of fluid overload and an enlarged liver. There may be signs of acute kidney failure in addition to the above symptoms.

A kidney biopsy reveals glomerulonephritis (inflammation of the glomeruli), which may indicate the cause.

Tests for the cause of the acute nephritic syndrome may include:

Culture of the throat or skin

Blood culture

ANA titer (lupus)

Serum complement (C3 and C4)

ANCA (antinutrophil cytoplasmic antibody for vasculitis)

Anti-glomerular basement membrane antibody

Treatment

The goal of treatment is to reduce glomerular inflammation. Hospitalization is required for diagnosis and treatment of many forms of acute nephritic syndrome. The cause must be identified and treated. This may include antibiotics or other medications or treatment.

Bedrest may be recommended. The diet may include restriction of salt, fluids, and potassium. Medications may include anti-hypertensive medications to control high blood pressure. Corticosteroids or other anti-inflammatory medications may be used to reduce inflammation.

Other treatment of acute kidney failure may be appropriate.

Support Groups
For information and support, see kidney disease support groups.

Expectations (prognosis)
The probable outcome is variable and depends on the disease responsible for the nephritis. When improvement occurs, symptoms associated with fluid retention (such as swelling and cough) and high blood pressure may resolve in a week or two, while urine tests take months to return to normal.

Children tend to do better than adults and usually recover completely. Only rarely do they develop complications or progress to chronic glomerulonephritis.

Adults do not recover quite as well or as rapidly as children. Although recurrence is unusual, at least one-third of adults whose acute nephritic syndrome recurs will eventually develop end-stage kidney disease.

Medical Encyclopedia

All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.

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